Saturday, February 6, 2010

Left Alone to Lick My Wounds

A particularly caustic nurse once told me that in her 20+ years of practice, she has learned the true role of the nurse is to take abuse while maintaining a smile for 12 hours. At the time I thought that she needed to retire and do so within the hour but after last week’s emotionally grueling shifts, I don’t think she was that far off from the truth. Every racist epithet was thrown at me, every combination of insults regarding my appearance, my intelligence, my competence and my worth as a human being were shouted from the triumvirate of asshole families in exam rooms 5, 6 and 7. Why would that be? Because they could not understand why they were ‘forced’ to wait so long to see the doctor when their elderly relatives were in various stages of ‘dying’. Calling in security seemed to incense them further since one of the family members was supposedly someone ‘important’. They only seemed to settle down once the doctor saw them and of course by then they were all as happy as pigs in shit. By the end of that shift, I was seething in raw white hot inarticulate rage because I was forced to endure those families’ abuse. And for what? I did everything within my scope of practice, I spent an exhausting amount of time with all of those entitled bastards about what the emergency department process entails for the patient, the role of the nurse and the physician in a patient’s care but it was all in vain. The charge nurse and I walked into their rooms to have them berate us in the most demeaning ways possible because they could not disimpact their heads from their asses to open their eyes to the reality that in an overwhelmed system, we were trying to provide the best care possible. Fuck trying to empathize with patients when they treat nurses like shit all because they feel that it’s their right to get whatever the fuck they want whenever they want.

As I write this, I’m still furious. Why is it that nurses have to put up with so much shit? Had I been working ANYWHERE ELSE, all three of those families would have been dragged out by the police but because they were ‘important’ and ‘sick’, I had to put up with those repulsive degenerates. Why is it that I would have been forced to attend some bullshit anger management class if I told them to go fuck themselves sideways with an IV pole right after I heard the supposedly dying patient call me a “dumb rag head bitch” because the blood pressure cuff was too tight? Why is it that my only outlet is to document thoroughly and write a lengthy email to my manager who’s just going to hold some idiotic meeting rehashing the same old policies about handling volatile patients? How the hell would my manager would understand exactly how viscerally humiliating racist slurs can be especially when she could never have experienced it herself? I don’t feel like the ‘better person’ for following the prescribed course of action. I feel completely powerless and incredibly angry because they got away scotch free while I’m left with no meaningful course of action. Now I get why nursing has such a huge problem with retention and it has nothing to do with changing a dirty diaper.

37 comments:

Here is what makes you an amazing nurse and a better person than those entitled racist assholes: I know that once you vent your righteous anger and rest your tired body and mind you will be right back to caring for people with kindness and empathy.

I work with nurses like you, Maha. Some nurses crack under the pressure and turn cruel, but I also know that you are not that sort of nurse.

Wow...there really are assholes of every color and creed. I work near Mexico, I get berated because I don't speak Spanish. I'm called "Whetta" (not sure if that is spelled right or not)...which means "White Bread"...which down here is not considered anything good to eat...trust me on that. And when it is spat at you because you can't juggle a bedpan, pitcher of ice water and fluff their pillow all at the same time, it really pisses you off. I'v had patient's DEMAND that somebody else take care of them because I am White and I speak with a "funny accent" (it's called Southern!), however when they find out there is no trading me...because the rest of the nurses are PHILLIPINO...they just decide to make my night a living hell. Welcome to the world where we are all seen as expendable! Until they need a code brown cleaned up. (Crappy drawers that is.)You are so right...sometimes it's actually attitudes that are effecting the retention of good nurses.

I don't know what to say.... you nurses do such an awesome job and those arseholes just don't get that they NEED you. I know there are a million excuses (stressed out etc) but you don't treat anyone like that.Bless that lot of you who are there to care for a living.Anthea

I'm sorry for your experience. As I get older I think sometimes I champion the nurse more than patient. I have never understood how why it's okay to leave the basic tenets of decent behavior at the door when you're hospitalized. Being ill or stressed does not get you off the hook for racist, homophobic or generally deragatory behavior. WE do not have to "understand" this or do some cultural or societal exploration as to the cause of this behavior. Sometimes an asshole is an asshole and needs to be called on it. No wonder they call nursing the profession of codependency...we are expected to engage in a lot of sick and unhealthy behaviors.Sorry I ranted on your turf. :)

I'm so sorry, that sounds awful. But just as an aside, I don't know anything about your manager but I don't know anyone on earth who could "never have experienced" viscerally humiliating racist slurs. I have personally been called a "honky-ass white bitch" and it felt awful. Isn't that a racist slur? What race is not vulnerable to racism?

Wow, I am sorry for your experience. I am not a nurse, but during 2+ years of volunteer work at hospitals I noticed differences. First I volunteered at a civilian, public hospital, and saw (and experienced) similar behavior. I switched to the military hospital, my husband was in the service at the time, and the patients behaved much better. If soldiers acted out MPs took care of the situation, and if family members acted out the service member was expected to get his family (usually spouse - little kids in pain can't really "act out") in line, or it would be held against him.

I'm so sorry that happened to you. And that it will again. What makes me (as an MD) upset is how patients like this can be two-faced - do they HONESTLY think that they can treat anyone like this (then be nice to anyone who can get them what they want) and everyone doesn't find out?? I keep patient behavior to clinic staff and nurses in mind when I see them and treat them accordingly.

And for the record, I had a patient call my MA a bitch in the clinic because the BP cuff was too tight. We're still mocking her, and it's four months later.

Honestly, I don't agree with the other commentors that just taking this sort of abuse and following procedure is what makes you a good nurse. All throughout life you are taught not to put up with racism, homophobia, or any sort of disgusting or cruel behaviour. But yet, as nurses you are taught to just be able to suck it up and take this abuse because its better to not lose your cool. If I saw this sort of shit behaviour out anywhere else I would be willing to take a stand no matter what. But in nursing, your own managers and peers wont even bat an eye at you, and say this is all part of the job. This is bullshit. It doesn't make you a "better nurse" to just play into such a messed up system that allows workers to be abused on a daily basis.-Marz

I'm enraged on your behalf. I know that feeling of suppressed rage that has you imagining telling em off and walking out the door triumphantly...I also know how it feels to have a manager more concerned with PR and image than the wellbeing of the nursing staff...hang in there, M!

It's not the same, but I share similar situations in paeds. Every parent's child is important, and they think that their child is more important above all others. I've been lucky that I haven't been subjected to any racist remarks, but the other verbal abuse is unbelievable. If I'm not there with a med RIGHT on the hour (5 min past was not acceptable), or that I wasn't around to get some formula for a mom because of the code blue happening next door, the colourful language that shouldn't even be uttered on a paediatric floor suddenly becomes really apparent.

My consolation prize is that I get to go home and call you up for a major bitch fest. :)

That is completely disgusting, and I am outraged on your behalf. I am consistently infuriated that our medical system fails to protect us from patients like this, when to say these things on the street would get you charged with harassment, and possibly with a hate-crime if they touched you. I hope a very VERY nasty tag is put on their file, so that everyone else will know to watch out!

Yeah. It sucks. My hospital won't even ban a patient who HIT me, because he was "sick" How do they get to be too competent to be restrained but so out of control at the same time? If I could make a living doing anything else, I'd be out of here.

Maha, I'm sorry. I wish I could tell you something comforting here, but all of that just sucks. I know how the wish-I-could-have-said-x eats at you; dealt with a (sexist) asshole on Friday and I've been mentally rehashing it all weekend. (It would have been politically/professionally inopportune to tell him off, so instead I made nice and ate shit. Yay, internship!)

And people who complain that the BP cuff is too tight are fucking ridiculous. I mean, for goddamn serious, people. Ugh.

Maha, this is one of the best blog posts I've ever read. Even as a 4th generation American I can completely identify. There are shifts when the crap-o-meter is full in the first 10 minutes and things go downhill from there. Even in the soft, touchy-feely world of oncology, emotional manure rolls downhill much too frequently, and white-hot (family) anger rules the day. I've got that smile-through-12-hours-of-abuse goin'...some shifts it's impossible to figure out what I got out of bed for. It's been my experience that we 'angry' ones are the ones who really 'get it'. When you get there, you'll see it, too. I promise. ;)

You hit the nail on the head, Maha. As hateful as these people are, I'm even more infuriated by the lack of support from management. It excuses their behavior and belittles your value. You shouldn't have to put up with it. I'm sorry.

Maha--I am so so so sorry that you were abused in such a horrible way at work. It is completely unacceptable and you absolutely *don't* have to put up with it. It is well within your right to refuse to treat a patient if they/their family are being abusive.

You can mention it to the charge nurse/manager and if they won't support you you can BET that the union would. Believe me I am not about rattling union cages but in a case like this--that is what they are for: to protect you at work.

It makes me so angry to read and know that this goes on for nurses everywhere, everyday. And I have seen the 180 pts pull with the doc and know how infuriating it is.

Staff ought to support each other in these situations and it simply doesn't happen 99% of the time.

I wish I could: a)give you a set of plates to smash on the floorb)ensure it would never happen again.

Thanks everyone for your support. Reading your comments did make me feel a lot better, though what still makes me angry is that had it not been me, those families would have set their sights on another nurse and dish it out to him/her just as badly. I sincerely think that my hospital should have thrown them out or perhaps even called the police - they were treated and they essentially faced no consequences for their behaviour. At the very least, all of those families should be placed on a trespass list for future visits because no other provider should be subjected to that kind of disgusting behaviour.

I don't work in health care and have a question: are you allowed to say to a patient "your hostility is inappropriate and if it continues I will call someone in to discuss with you what is and is not appropriate here"? Then the charge nurse could go in and tell them that they don't tolerate racism, hostility, etc.

Could you or the charge nurse tell them they will need to use another ER in the future if they continue with inappropriate behavior? I know you can't refuse to treat someone in an emergency but from what I read most of the folks who show up in the ER don't truly have emergencies.

As a healthcare professional myself, I know what you're talking about. It is frustrating and inevitable. Hopefully you wont dwell on it and let it eat you up. Everybody in this business gets this treatment, regardless of race.

I am not a Dr, nurse, lawyer or anyone in th ehealthcare field. I was just looking for information on VRE as I was not informed on it enough by my Dr, when I was in the hospital. I can only say 1 thing to you...As a human to another human; I AM SORRY.

One of the many dreams that gets me thru some shifts is this: on my very last day at work, I get to say EVERYTHING I have ever wanted to and back at certain patients and their families....it helps me on the drive home!

I love your blog! I came across it after a particular grueling night similar as the one you just described. I needed to know I wasn't alone and your blog was extremely comforting.

Let me tell you it is no different in inpatient units. I too am new in the field, about a 1 1/2 now, and in that last year I too have been plagued by this very same phenomenon. And my manager was just as responsive.

I'm also finding the physical violence is also increasing in wards. A couple weeks ago a gun was pulled on a medicine floor and nurse on my unit was punch in the face while taking a BP. Management response? They decided to roll out their new "least restraint" policy.

Anon - a gun was pulled on your unit? That's beyond frightening and ridiculous! I can't believe that the gun puller and his/her family were immediately thrown out and had a restraining order put against them. Yes, it is our job to care for the sick but no one should have to face the possibility of DYING at work. That's disgusting beyond belief.

Question to OP: How do you know your manager,"could never have experienced it (racial slurs) herself"? Racism and Counter-Racism are both problems in our country, both are founded on 3 things, misunderstanding, assumption and gross generalization. It seems like you may have made an assumption here, am I correct? What are your thoughts?

I hear you, seems every night at work I get abused. I work LTC and those people get NASTY when they don't get their prn meds right when they want them. I'll go to work tonight with a smile on my face though....wishing they could F*** themselves with the IV pole too! LOL

Tell me who it was...and I'll take care of them...you just let me know Maha and I'll make sure they never make another racist slur ever again! Btw I know you can't tell me who or where they live...but I hate them! and they are fools! racist damn poo heads!

I've been following you for awhile and you are AWESOME! Keep up the great work.

I'm not in the healthcare field, but dealing with the challenges of a disabled mother has put me in the thick of things.

I have been through some grueling times with my mom, in and out of the ER and rehab and back again. No matter how stressful and scary things get, someone has to remain calm and maintain composure.

The old adage: "You can collect more flies with honey than with vinegar." is my favorite and I practice it every day. Each time I have been in a healthcare setting with my mom, I have been treated with respect because of the respect I give. (In fact, I think we may have received better care because I wasn't demanding narcotics!)

There is absolutely NO reason to treat another human being, in any way, that you would not like to be treated.

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I like my job. I do not want to lose it for violating patient confidentiality. I have a fairly active imagination so altering identifying details is something I enjoy. Everything here is altered to protect patient confidentiality. If you think that a story is referring to you, it’s not. If you think a picture is from your medical exam, it’s not.